MRS. SUSAN VICUNA BRAVO (NPI# 1689881310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689881310 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN VICUNA BRAVO |
| Credential | F.N.P. |
| Practice Address |
1415 Ross Ave Calexico Outpatient Center El Centro CA 92243-4306 |
| Mailing Address |
676 Yucca St Imperial CA 92251-8924 |
| Practice Telephone | 7603570508 |
| Practice Fax Number | 7603570817 |
| Mailing Telephone | 7607910442 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | NP16654 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
16654 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FNP PROVIDER | 16654 | 01 |
| CA | 1689881310 | 05 | |
| CA | RN430309 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114399193 | Susan Bravo | Counselor | 2405 Bemiss Rd, Valdosta, GA 31602-1936 | 2015-10-29 |
| 1679592273 | Susan E Bravo | Nurse Practitioner | 2150 Se Salerno Rd, Stuart, FL 34997-6572 | 2006-07-18 |
| Street Address |
1415 ROSS AVE CALEXICO OUTPATIENT CENTER |
| City | EL CENTRO |
| State | CA |
| Zip Code | 92243-4306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861494569 | Michael K Berry | Emergency Medicine | 1415 Ross Ave, El Centro, CA 92243-4306 | 2005-08-12 |
| 1952913022 | Sandra Iris Torres | Nurse Practitioner | 1415 Ross Ave, El Centro, CA 92243-4306 | 2020-08-20 |
| 1083237648 | Y Hoang | Pharmacist | 1415 Ross Ave, El Centro, CA 92243-4306 | 2020-05-18 |
| 1164052221 | Stephen L Jaime | Registered Nurse | 1415 Ross Ave, El Centro, CA 92243 | 2020-01-17 |
| 1033759790 | Carolina Dela Peza | Health Educator | 1415 Ross Ave, El Centro, CA 92243 | 2020-01-10 |
| 1811537566 | Marsella Mayoral | Health Educator | 1415 Ross Ave, El Centro, CA 92243 | 2020-01-10 |
| 1225671902 | Kaitlyn Elise Offhaus | Dietitian, Registered | 1415 Ross Ave, El Centro, CA 92243-4306 | 2019-10-24 |
| 1437706397 | Hd Elshire IIi Md Phd Facs, Inc | Clinic/Center | 1415 Ross Ave, El Centro, CA 92243-4306 | 2019-08-24 |
| 1912470956 | Valley Anesthesia Specialists Inc | Anesthesiology | 1415 Ross Ave, El Centro, CA 92243-4306 | 2019-01-02 |
| 1376015578 | Steven E. Blum Do PC | Anesthesiology | 1415 Ross Ave, El Centro, CA 92243-4306 | 2018-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1346856671 | Ana Lilia Solorio | Health Educator | 1415 Ross Ave., El Centro, CA 92243 | 2020-09-22 |
| 1467073775 | Mabel Janet Castro-ley | Counselor | 22 N 8th St., El Centro, CA 92243 | 2020-04-28 |
| 1831723030 | Guadalupe Heredia | Registered Nurse | 1415 Ross Ave El Centro Ca, El Centro, El Centro, CA 92243 | 2020-02-26 |
| 1851948061 | Hamlet Khachatryan Dds, Inc. | Dentist | 1698 Cruickshank Drive, Suite B, El Centro, CA 92243 | 2019-08-22 |
| 1104478924 | Courtney Barker | Occupational Therapist | 1161 Main St., El Centro, CA 92243 | 2019-07-11 |
| 1891350997 | Amy Nguyen Dao | Nurse Practitioner | 852 Danenberg Drive, El Centro, CA 92243 | 2019-05-03 |
| 1538723622 | Patrick H Dao | Nurse Practitioner | 852 Danenberg Dr., El Centro, CA 92243 | 2019-04-24 |
| 1114494861 | Alba Care Mental Health Serrvices | Counselor | 1498 Main Street, El Centro, CA 92243 | 2018-10-31 |
| 1922503085 | Joanne P. Goode | Nurse Practitioner | El Centro Health Clinic, 651 Wake Avenue, El Centro, CA 92243 | 2018-03-29 |
| Find all providers in zip 92243 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891350997 | Amy Nguyen Dao | Nurse Practitioner | 852 Danenberg Drive, El Centro, CA 92243 | 2019-05-03 |
| 1538723622 | Patrick H Dao | Nurse Practitioner | 852 Danenberg Dr., El Centro, CA 92243 | 2019-04-24 |
| 1083078547 | Jayme Lynn Storms | Nurse Practitioner | 1503 North Imperial Avenue, Suite 105-b, El Centro, CA 92243 | 2016-04-11 |
| 1053705087 | Venus Nguyen | Nurse Practitioner | 2456 S Cypress Dr, El Centro, CA 92243-6112 | 2015-03-27 |
| 1114980471 | Irma Garcia | Nurse Practitioner | 1550 N Imperial Ave, Suite 1, El Centro, CA 92243-6304 | 2006-04-08 |
| 1285621086 | Arlyn Ruth Duval | Nurse Practitioner | 1745 S Imperial Ave, El Centro, CA 92243-4243 | 2005-10-05 |
| 1568077345 | D'andre York | Nurse Practitioner | 702 Wake Ave, El Centro, CA 92243-7502 | 2020-09-09 |
| 1952913022 | Sandra Iris Torres | Nurse Practitioner | 1415 Ross Ave, El Centro, CA 92243-4306 | 2020-08-20 |
| 1124630736 | Christina Galindo | Nurse Practitioner | 1271 Ross Ave, El Centro, CA 92243-4304 | 2020-08-17 |
| 1760035992 | Alexis Lynell Brown | Nurse Practitioner | 1590 S Imperial Ave, El Centro, CA 92243-4241 | 2019-07-17 |
| Find all providers in EL CENTRO | ||||
Please comment or provide details below to improve the information on MRS. SUSAN VICUNA BRAVO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.